Cheek augmentation with Bio-Alcamid in facial lipoatrophy in HIV seropositive patients

Lipoatrophy of the face in HIV seropositives are not susceptible to satisfactory correction by using single cosmetic surgery. The limitation of the available filler products to augment and to correct the facial defects in facial lipoatrophy is mainly inherent in the amount of substance that can be implanted for the correction of lipoatrophy. Using Bio-Alcamid, which is an injectable, biocompatible, nontoxic, nonallergenic soft tissue filler designed to correct tissue deficits of various volume by intratissue administration, 9 nonrelated HIV seropositive patients with facial lipoatrophy (7 males and 2 females, age 43 +/- 6 years) underwent cheek augmentation. From 7 mL to 16 mL of substance was injected each on both cheeks per application up to a maximum total of 25 mL. with a mean amount of 12 mL +/- 4 mL. The median follow up time was 2 years. The results revealed that the corrections have remained essentially unchanged throughout the period of follow up. Bio-Alcamid maintained the form and blend with the surrounding tissues. The surgical outcome was evaluated according to the analysis of photographs obtained before and after surgery, the analysis of pre- and postoperative measurements, and patients' self-judgment. The level of satisfaction was significantly high: in 63% of the cases, the result was judged to be excellent and in 32%, good. Only in 5% of the cases the result was considered poor. The present study strongly suggests that Bio-Alcamid is suitable for the correction of remarkable defects of facial atrophy, otherwise treatable only by surgery with myofascial free flaps. In addition, it permits a simplification of facial reconstruction and rejuvenation.